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Promoting Patient-Centered Counseling to Reduce Inappropriate Diagnostic Tests

Not Applicable
Completed
Conditions
Osteoporosis
Primary Care
Headache
Low Back Pain
Magnetic Resonance Imaging
Unnecessary Procedures
Registration Number
NCT01808664
Lead Sponsor
University of California, Davis
Brief Summary

In this study, the investigators will develop and evaluate a novel intervention using standardized patients (SPs) -- or actors playing the roles of patients -- to enhance physicians' patient-centered counseling skills regarding two frequently overused, potentially inappropriate services in primary care: magnetic resonance imaging (MRI) for acute low back pain and bone densitometry in women at low-risk for osteoporosis. The investigators will further evaluate whether intervention effects on physician patient-centeredness generalize to counseling regarding other costly, unnecessary diagnostic tests.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
61
Inclusion Criteria
  • Resident physician in family medicine or internal medicine who deliver primary care at one of two hospital-based primary care clinics at the University of California, Davis Medical Center Sacramento
Exclusion Criteria
  • Anticipated graduation in less than one year from enrollment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Number of inappropriate diagnostic tests ordered9 months

Investigators will assess via blinded, standardized chart review whether study physicians ordered inappropriate diagnostic tests for unannounced standardized patients who request testing during three follow-up visits occurring 3 to 9 months post-randomization.

Secondary Outcome Measures
NameTimeMethod
Use of patient-centered counseling techniques9 months

Physician use of patient-centered counseling techniques as assessed via masked recordings of three standardized patient visits

Actual diagnostic test ordering among real patients9 months post-intervention

Among real patients seen by study physicians, we will assess diagnostic test ordering among actual adult patients during the post-intervention period. We will also assess comparable diagnostic test ordering during the pre-intervention period to enable adjustment for baseline test ordering.

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